Wiki consolidation question

[tarab524]

80055 ? OBSTETRICS PANEL

CPT? 80055: OBSTETRIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: BLOOD COUNT, COMPLETE (CBC), AUTOMATED AND AUTOMATED DIFFERENTIAL WBC COUNT (85025 OR 85027 AND 85004) OR BLOOD COUNT, COMPLETE (CBC), AUTOMATED (85027) AND APPROPRIATE MANUAL DIFFERENTIAL WBC COUNT (85007 OR 85009) HEPATITIS B SURFACE ANTIGEN (HBSAG) (87340) ANTIBODY, RUBELLA (86762) SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART) (86592) ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE (86850) BLOOD TYPING, ABO (86900) AND BLOOD TYPING, RH (D) (86901)

Question ? if we bill a CBC and no DIFF, and all other codes are present, do we NOT bundle because a DIFF was not billed?

 

[rlh27]

I found this on the OIG website. It may be helpful to read through a little bit of this but I cut and paste the important parts.
The submission of a claim for tests that were either not ordered or were not performed could subject a provider to sanctions under administrative, civil or criminal law.
https://oig.hhs.gov/authorities/docs/cpglab.pdf

Also I found this on CPT Assistant:

Guidelines for reporting laboratory panels are provided in CPT? Assistant January 1998, ?1998 CPT Changes for Pathology and Laboratory Codes?, which states:

All Organ and Disease Oriented Panels must include the tests listed with no substitutions. If only part of the tests included in a defined panel are performed, the panel code should not be reported. Instead, the tests should be reported with the individual codes for the tests. If tests are performed in addition to those listed in the defined panel, the additional tests should be reported separately, in addition to the panel code, using the individual CPT codes for the tests.

 

[BenCrocker]

That's why in the panel it's broken down to the different types of tests that are comonly done and that's why the CPT code is provided.